Periconception folic acid lowers risk of nonsyndromic cleft lip, palate in child

Folic acid supplementation (FAS) around the time of pregnancy may help reduce the risk of nonsyndromic cleft lips or palates (NsCL/P) in offspring, a recent China study has found.

The researchers conducted a population-based case-control study including 807 singleton infants with nonsyndromic oral clefts (NsOC) and 8,070 healthy controls. Information regarding maternal folic use was drawn from the Chengdu Maternal and Infant Healthy Surveillance system.

Of the 807 NsOC infants, 247 had NsCLs, 191 had NsCPs, and 369 had both (NsCLP). Periconceptionally, 81 percent of mothers who gave birth to infants with nonsyndromic clefts took FAS, as opposed to 91 percent in the control group. More NsCL/P and NsCP mothers did not take FAS during the preconception period compared with controls (20.6 percent and 12.5 percent vs 9.2 percent).

Nonconditional logistic regression analysis showed that periconception use of FAS significantly reduced the risk of NsCL/P (odds ratio [OR], 0.41, 95 percent confidence interval [CI], 0.33–0.51). This was driven mostly by a drop in the likelihood of NsCLs (OR, 0.42, 95 percent CI, 0.30–0.58) and NsCPs (OR, 0.41, 95 percent CI, 0.31–0.54). NsCP risk was unaffected.

Notably, FAS use during the pre- and postconception periods also had similar effects, lowering the likelihood of infant NsCL/P significantly.

“Larger-sample-size studies are warranted to elucidate the association with NsCP and to determine whether women can benefit more from supplementation starting before last menstrual period,” the researchers said. “It is of paramount importance for women of childbearing age to become aware of that maternal FAS can not only reduce the risk of neural tube defects, but also reduce the risk of NsCL/P.”